Extra-amniotic balloon for preinduction cervical ripening: a randomized comparison of weighted traction versus unweighted

Abstract

Objective: To determine whether a weighted versus unweighted balloon catheter achieved a shorter first stage of labor. Methods: This was a randomized trial of patients undergoing induction with Bishop score <4. Women were randomized to weighted balloon catheter with 1000 mL fluid bag or unweighted catheter taped to the thigh. Results: A total of 60 women were randomized. The time from balloon catheter insertion until discontinuation was significantly longer in the unweighted group 4.62 ± 0.65 h versus 1.59 ± 0.2 h in the weighted group (p = 0.001). This resulted in longer cervical ripening/first stage of labor in the unweighted (18.52 ± 0.96 h) versus weighted group (15.3 ± 0.99 h) (p = 0.025). The unweighted balloon catheter had a shorter first stage of labor as gravidity increased (p = 0.007) and as race went from white to non-white (p = 0.003). There was no difference in perceived pain after balloon insertion (p = 0.0942), or Bishop score after balloon discontinuation (p = 0.1661). Conclusion: The total time from cervical ripening to the end of the first stage of labor is significantly shortened with the weighted balloon catheter.

Keywords::

• balloon
• cervical ripening
• induction
• mechanical
• traction
• weighted

Acknowledgements

Susan Steelman, M.L.I.S., Associate Librarian, University of Arkansas for Medical Sciences Library, for her assistance in the literature search for publications about cervical ripening and a weighted balloon catheter.

Declaration of interest: The authors report no declarations of interest. The views expressed in this article are those of the authors and do not necessarily reflect the official policy or position of the Department of the Navy, Department of Defense or the United States Government. We are military service members. This work was prepared as part of our official duties. Title 17 U.S.C. 105 provides that “Copyright protection under this title is not available for any work of the United States Government.” Title 17 U.S.C. 101 defines a United States Government work as a work prepared by a military service member or employee of the United States Government as part of that person’s official duties.